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Introduction Depression is common, increasing among adolescents and carries risk of disability, lower educational achievements, cardiovascular disease, substance abuse, self-harm and suicide. The effects of evidence-based treatments with medication or psychotherapy are modest. Aerobic exercise is a promising intervention for adolescents with depression, but available studies are hampered by methodological shortcomings. This study aims to evaluate aerobic group exercise versus an active comparator of leisure group activities in adolescents from clinical services with mild-to-moderate depression.Methods and analysis This study is a multicentre randomised controlled trial at four psychiatric clinics in Sweden. Participants (n=122) will be randomised 1:1 to group exercise delivered by exercise professionals and supported by mental health (MH) workers or leisure activities lead by the same MH workers for 1 hour three times a week for 12 weeks. Participants will be assessed at baseline, single blind after 13 weeks and 26 weeks and openly after 1 year. Participants randomised to the leisure group will be offered exercise in the open phase. The primary outcome is clinician-rated Children’s Depression Rating Scale-Revised. Secondary outcomes are self-rated Quick Inventory of Depressive Symptomatology, self-rated functioning; clinician-rated improvement and functioning; objectively measured aerobic capacity, muscular strength, muscular endurance, body composition and presence or activity of selected biological markers of neuroprotection and neuroinflammation in blood samples. Further outcomes are cost-effectiveness and adolescents’, parents’ and coaches’ experiences of the interventions and an exploration of how the adolescents’ health and lifestyle are influenced by the interventions through qualitative interviews.Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Ref. 2021-05307-01). Informed consent in writing will be provided from patients and parents of participants below 15 years of age. The results of this study will be communicated to the included participants and healthcare providers and also submitted for publication in peer-reviewed journals.Trial registration number NCT05076214.

Informal risk sharing within social networks and formal financial contracts both enable households to manage risk. We find that financial contracting reduces participation in social networks. Specifically, increased crop insurance usage decreased local religious adherence and congregation membership in agricultural communities. Our identification utilizes the Federal Crop Insurance Reform Act of 1994 that doubled crop insurance usage nationally within a year, although changes in usage varied across counties. Difference-in-difference and Spatial First Difference tests confirm that households substituted insurance for religiosity. This substitution was associated with reductions in crop diversification and crop yields, indicating an increase in moral hazard. [ABSTRACT FROM AUTHOR]

Student teachers’ experiences of professional ethics, as lived practice, need to be visualized and verbalized to support their ability to develop an ethical practice. The aim of this article is to discuss the lived experiences of professional ethics from beginning teachers’ internship, based on a phenomenological study. Some of the essential meanings are interpreted in relation to the tension between responsibility and accountability that is emerging from neoliberal influences in teacher education. Inspired by Reflective Life World Research (RLR), interviews were conducted with student teachers specializing in preschool and elementary school. The empirical data was analyzed in order to determine the meanings that constitute the lived experience of professional ethics for early career teachers. By identifying the implications of professional ethics in neoliberal times, teacher educators can more easily observe and communicate the manifestations this has for teaching. Discussions and observations of professional ethics can stimulate student teachers’ learning as part of teacher education discourse.

This article opens a new perspective on Finland’s Cold War history by highlighting the role of the Finnish Broadcasting Company (YLE) in providing information about the German Democratic Republic as a particular polity, economy, and key player in the European Cold War landscape. The analysis is based on search results from the YLE digital database (Metro) from 1970–1989, and it is supported by documents from the German Broadcasting Archive [Deutsches Rundfunkarchiv] and the YLE company archive. The archive documents and metadata testify about a long-term interest in East Germany in Finnish television, as well as long-term contacts and collaboration between East German and Finnish television companies, in the executive as well as at grass roots levels.

Both in research and in the Swedish curricula, positive emotions such as joy, pleasure and desire are said to stimulate learning. However, it is not clear what the meaning of joy is in relation to learning. The purpose of this phenomenological study is to gain knowledge about the essential meanings of the phenomenon joy in learning for children aged 9 and 12 years in compulsory school. The questions are as follows: What meanings constitute the phenomenon joy in learning in the current context? What implications do the findings have for teaching? The study is phenomenological and is based on interviews with or written stories by the participating children. The findings indicate how joy stimulates learning and emerges when children understand and ‘own’ their learning process. Teachers are important as ‘facilitators’ for joy in learning through being supportive and inspiring. Joy in learning during lessons is related to joy and friendship during school breaks. Teachers’ decisive importance for joy is discussed in relation to various modalities of pedagogical contact. Conclusions can be drawn that school breaks need attention from a learning perspective and that children need teacher support to understand their learning process.

Teaching is an ethical activity and in order to ensure a high quality in teaching, ethics need to be visualized and verbalized. In a phenomenological empirical study with student teachers as participants, data were analyzed in order to express the essential meanings of professional ethics. The essence can be described as the meanings that in spite of different contexts are relatively persistent. In phenomenology, the possibility of expressing the essence of a phenomenon is interpreted in different ways. In this article, the author argues that the essence is needed to verbalize ethics in teaching tentatively as a kind of ethical code or guideline for becoming teachers. Some of the essential findings stemming from the empirical study mentioned above are compared with the ethical principles formulated in Lärares Yrkesetiska Principer (2001) by the two Swedish unions, Lärarförbundet and Lärarnas Riksförbund, to argue for the importance of formulating the essence.

The aim of this study was to actively integrate expertise of persons living with spina bifida, to explore conditions embedded in their everyday life. This was important because young adults with spina bifida risk not being able to fully participate in the community on equal terms and in accordance with their own preferences. Photovoice, a community-based participatory research approach, was utilized to engage participants through dialogue and photography. An exhibition was created to share results with community and stakeholders. An overarching theme that characterized the experiences of the group was, “an adaptation for us, but it works for no one”. Findings are presented as: “Accessibility—a never-ending project,” “Tensions of a normative view,” and “Power to influence.” Findings integrated everyday life metaphors photographically depicted by broken elevators, unsafe transportation, closed doors and not experiencing real opportunities of involvement. Tensions in everyday life experienced by persons living with spina bifida can inform conditions relevant and necessary to support community participation, particulary among persons living with disability.

A severe hemorrhage can result in death within minutes, before professional first responders have time to arrive. Thus, intervention by bystanders, who may lack medical training, may be necessary to save a victim's life in situations with bleeding injuries. Proper intervention requires that bystanders accurately assess the severity of the injury and respond appropriately. As many bystanders lack tools and training, they are limited in terms of the information they can use in their evaluative process. In hemorrhage situations, visible blood loss may serve as a dominant cue to action. Therefore, understanding how medically untrained bystanders (i.e., laypeople) perceive hemorrhage is important. The purpose of the current study was to investigate the ability of laypeople to visually assess blood loss and to examine factors that may impact accuracy and the classification of injury severity. A total of 125 laypeople watched 78 short videos each of individuals experiencing a hemorrhage. Victim gender, volume of blood lost, and camera perspective were systematically manipulated in the videos. The results revealed that laypeople overestimated small volumes of blood loss (from 50 to 200 ml), and underestimated larger volumes (from 400 to 1900 ml). Larger volumes of blood loss were associated with larger estimation errors. Further, blood loss was underestimated more for female victims than male victims and their hemorrhages were less likely to be classified as life-threatening. These results have implications for training and intervention design.

Abstract During the pregnancy associated syndrome preeclampsia (PE), there is increased release of placental syncytiotrophoblast extracellular vesicles (STBEVs) and free foetal haemoglobin (HbF) into the maternal circulation. In the present study we investigated the uptake of normal and PE STBEVs by primary human coronary artery endothelial cells (HCAEC) and the effects of free HbF on this uptake. Our results show internalization of STBEVs into primary HCAEC, and transfer of placenta specific miRNAs from STBEVs into the endoplasmic reticulum and mitochondria of these recipient cells. Further, the transferred miRNAs were functional, causing a down regulation of specific target genes, including the PE associated gene fms related tyrosine kinase 1 (FLT1). When co-treating normal STBEVs with HbF, the miRNA deposition is altered from the mitochondria to the ER and the cell membrane becomes ruffled, as was also seen with PE STBEVs. These findings suggest that STBEVs may cause endothelial damage and contribute to the endothelial dysfunction typical for PE. The miRNA mediated effects on gene expression may contribute to the oxidative and endoplasmic reticulum stress described in PE, as well as endothelial reprogramming that may underlay the increased risk of cardiovascular disease reported for women with PE later in life.